A systematic review of case reports of hepatic actinomycosis

Chegini, Zahra; Didehdar, Mojtaba; Tabaeian, Seidamir Pasha; Khoshbayan, Amin; Shariati, Aref

doi:10.1186/s13023-021-01821-5

Cited by 14 publications

(21 citation statements)

References 77 publications

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“…Only sporadic cases and case series of HA have been reported. The present review revealed the global distribution of the disease with its burden being higher in Asia, as recently reported [98]. A male predominance (3:2.3) was observed, and most patients were immunocompetent.…”

Section: Discussionsupporting

confidence: 79%

A 60-Year Literature Review on Hepatic Actinomycosis

et al. 2022

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Hepatic actinomycosis (HA) is a rare infection with indolent course, atypical clinical manifestations, nonspecific laboratory and imaging findings and challenging diagnosis. We describe a case of a 35-y-old female who developed HA 2 weeks after gastrectomy. In addition, we analyzed clinical characteristics and outcome of 157 additional cases of HA identified in a 60 years’ literature review. Patients with HA were predominantly male (57%) and more than one-half were between 40 and 70 years of age. Of interest, the infection was cryptogenic in 80.8% of cases. Risk factors for HA were identified in 63.1% of the patients. Clinical presentation included fever (57.7 %), abdominal pain (52.1%), weight loss (45.1%), anorexia (27.5%), fatigue and chills (12.7% each), and malaise (12%) over a 2.35±3.5 months period. Leucocytosis, elevated alkaline phosphatase, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were the most frequent laboratory findings. Radiologic imaging revealed that the right lobe was more frequently affected (62.5%) with a single lesion found in two-thirds of cases. Diagnosis was achieved by histopathologic examination in 70.6% of cases. Cultures yielded Actinomyces in 45 instances, with A. israelii being the most frequent species. Less than one half of the patients were treated only with antibiotics, while the others received combined medical and surgical treatment. The median duration of antibiotic therapy was 135 days (range: 7-730 days). The presence of multiple lesions or solid tumor like lesions was significantly associated with medical therapy alone. The outcome was favorable in most cases (94%). Although rarely encountered, HA should be considered in patients with a chronic or subacute inflammatory process of the liver, in order to promptly diagnose and treat.

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Section: Discussionsupporting

confidence: 79%

A 60-Year Literature Review on Hepatic Actinomycosis

et al. 2022

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“…The abundance of Actinomyces contributes to the root caries, periodontal infections, [ 21 ] and actinomycosis. [ 22 ] The abundance of Haemophilus in saliva is significantly decreased in the primary sclerosing cholangitis patients compared to ulcerative colitis patients. [ 23 ] Porphyromonas endodontalis is enriched in periodontal disease [ 24 ] and Prevotella spp is an important pathobiont that participates in human chronic inflammation.…”

Section: Resultsmentioning

confidence: 99%

Multiomics Analysis Reveals the Impact of Microbiota on Host Metabolism in Hepatic Steatosis

Zeybel

Arif

et al. 2022

Advanced Science

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Metabolic dysfunction-associated fatty liver disease (MAFLD) is a complex disease involving alterations in multiple biological processes regulated by the interactions between obesity, genetic background, and environmental factors including the microbiome. To decipher hepatic steatosis (HS) pathogenesis by excluding critical confounding factors including genetic variants and diabetes, 56 heterogenous MAFLD patients are characterized by generating multiomics data including oral and gut metagenomics as well as plasma metabolomics and inflammatory proteomics data. The dysbiosis in the oral and gut microbiome is explored and the host-microbiome interactions based on global metabolic and inflammatory processes are revealed. These multiomics data are integrated using the biological network and HS's key features are identified using multiomics data. HS is finally predicted using these key features and findings are validated in a follow-up cohort, where 22 subjects with varying degree of HS are characterized.

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Section: Discussionmentioning

confidence: 99%

“…According to a recent systematic review, 64 patients with HA have been reported in the English literature between 2000 and 2020 [5] . The most susceptible group of HA was men, 50–70 years of age [5] . A history of abdominal surgery, pelvic colonization due to the use of an intrauterine device, and oral diseases or dental surgery are known risk factors for HA.…”

Section: Discussionmentioning

confidence: 99%

“…A history of abdominal surgery, pelvic colonization due to the use of an intrauterine device, and oral diseases or dental surgery are known risk factors for HA. The treatment should focus on antibiotic therapy rather than surgery because the treatment outcome is acceptable with a mortality rate of 1.5% [5] ; however, the common clinical manifestations (abdominal pain, fever, and/or weight loss) and medical imaging findings (most frequently a single mass) lead to an initial diagnosis of malignant hepatic tumor in 50% of patients [5] . PET is invaluable in managing liver lesions, in particular suspected liver metastases.…”

Section: Discussionmentioning

confidence: 99%

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Hepatic actinomycosis after total pancreatectomy: A case report

Sakaguchi

Hashimoto

Satoi

et al. 2021

International Journal of Surgery Case Reports

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Introduction and importance Hepatic actinomycosis (HA) is a rare infection mimicking a malignancy. HA after total pancreatectomy for a pancreatic tumor has not been reported. Case presentation A 70-year-old woman with a history of gastrectomy and sigmoidectomy for benign lesions, underwent a total pancreatectomy for a non-invasive, intraductal papillary mucinous carcinoma (IPMC). She required partial resection of the transverse colon due to insufficient blood flow and had an anastomotic failure. Four months later, she developed a fever and effusion from the upper abdominal midline incision. No bacteria were cultured from the effusion. Contrast-enhanced computed tomography demonstrated an 80-mm iso-vascular liver mass. A slightly high-signal intensity on T2-weighted magnetic resonance imaging was demonstrated. Positron emission tomography (PET) showed a standardized uptake value of 11.9 at the liver mass. The percutaneous liver biopsy did not establish a diagnosis. Because a malignancy could not be ruled out, an exploratory laparotomy was performed. A tissue sample revealed aggregates of branched filamentous microorganisms; actinomycosis was diagnosed. Oral amoxicillin for 4 months resolved the mass. Clinical discussion This patient had several causative factors for HA, including multiple surgical procedures involving the gastrointestinal tract, reconstruction of the biliary tract, anastomotic failure of the transverse colon, and diabetes mellitus following total pancreatectomy. Based on the past treatment history for IPMC and PET findings mimicking a malignancy, a laparotomy was performed to biopsy the lesion. Typically, penicillin is recommended for >6 months. Conclusion A rare case of HA mimicking a malignancy after a total pancreatectomy for IPMC is presented.

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A systematic review of case reports of hepatic actinomycosis

Cited by 14 publications

References 77 publications

A 60-Year Literature Review on Hepatic Actinomycosis

A 60-Year Literature Review on Hepatic Actinomycosis

Multiomics Analysis Reveals the Impact of Microbiota on Host Metabolism in Hepatic Steatosis

Hepatic actinomycosis after total pancreatectomy: A case report

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